# MAGNOLIA MANOR MANAGEMENT INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Magnolia Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639379902
- **Authorized official:** MR. WAYNE POWELL (DIRECTOR)
- **Authorized official phone:** (469) 293-0002

## Contact information

- **Practice address:** 510 E BONHAM ST, JEFFERSON, TX 75657-1506
- **Practice address phone:** (903) 665-3903
- **Practice address fax:** (903) 665-2410
- **Mailing address:** 510 E BONHAM ST, JEFFERSON, TX 75657-1506
- **Mailing address phone:** (903) 665-3903
- **Mailing address fax:** (903) 665-2410

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 07/24/2007
- **Last updated:** 07/24/2007